Serositis and desquamation of fingers and toes.

نویسندگان

  • Andrew D'Silva
  • Ruth Ash
  • Robert Gerber
چکیده

To cite: D’Silva A, Ash R, Gerber R. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013201610 DESCRIPTION A 19-year-old male patient presented with painful skin lesions on his hands, feet and face with concurrent central sharp chest pain. This chest pain was familiar and had occurred and subsided 3 months prior. At that time, a diagnosis of acute pericarditis had been applied. In the interim, the patient had lost weight, experiencing mouth ulcers and arthralgia of the small joints of the hands, wrists and ankles. Clinical examination was remarkable for desquamation of the fingertips and feet, digital infarcts and erythematous lesions on the lips, eyelids and ears (figures 1 and 2). Urine dipstick was negative for blood and protein. A transthoracic echocardiogram (figure 3 and videos 1 and 2) demonstrated pericardial and pleural effusions, with normal valves. His blood tests demonstrated microcytic anaemia and lymphopenia. Ferritin levels were elevated with low serum iron and folate levels. Inflammatory markers were raised with erythrocyte sedimentation rate 55 mm/h (normal range 1–12 mm/h), C reactive protein 28 mg/L and reduced levels of complement. A direct agglutination test was positive indicating haemolytic anaemia. Serological investigations showed a strong positive titre antinuclear antibody >1:2560 and positive double-stranded DNA 314 iu/mL.

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عنوان ژورنال:
  • BMJ case reports

دوره 2014  شماره 

صفحات  -

تاریخ انتشار 2014